sulconazole solution (Exelderm) — CareFirst (Caremark)

Initial criteria

• Authorization may be granted when the requested drug is being prescribed for the treatment of Tinea Cruris when ALL of the following criteria are met:
• The requested drug is NOT being used in a footbath.
• The requested drug is ANY of the following: ciclopirox cream, suspension/lotion (Loprox cream, suspension/lotion), clotrimazole cream, solution, econazole cream, ketoconazole cream, luliconazole cream (Luzu), naftifine cream, 1% gel (Naftin 1% gel), oxiconazole cream, lotion (Oxistat), sulconazole cream, solution (Exelderm).

Approval duration

3 months